FREDERICKSBURG, Va. (AP) — Katie Mueda's life changed in an instant in 2011.
One minute she was on the soccer field, and sports were her life.
The next, a ball collided with her head, spelling the end of contact sports for the now 16-year-old Massaponax High School junior who sustained a severe concussion.
The effects of the collision would plague her for years.
Mueda is only one of more than 100,000 people estimated by the CDC to have been treated for a concussion each year.
In Spotsylvania County her severe concussion wasn't an anomaly.
While looking for resources, she came across others with the same condition. Cailin Davis, 16, who attends Spotsylvania High School, Emily Hunter, 17, also of Spotsylvania High, and Brie Boothby, 17, of Riverbend High, all sustained severe concussions while playing sports, and each didn't know what to do after being injured.
So the girls, who have become a close-knit group of friends, are setting up a support group for students like themselves who have questions after sustaining a traumatic brain injury.
The group will be called "Concussion Connections."
For Emily, the worst part is not getting to play soccer.
The midfielder worries that her time off the field will affect athletic scholarship opportunities.
She has sustained multiple head injuries. The first came from heading the ball, but the second, more severe, concussion was the result of a head-to-head collision while playing.
The second took her out of the game for six months and made school challenging.
Concentrating for long periods of time gave her headaches, and she needed to take breaks during the day.
"It's hard, because to everyone else you look fine," she said.
Cailin, whose injury resulted from a cheerleading accident, said she's experienced doubt from classmates that her symptoms are real.
"Just because we look OK doesn't mean we feel OK," she said. "And the reason they think that is just because there's not a lot of information out there about concussions."
What all of them — Katie, Emily, Cailin and Brie — discovered was that local resources are lacking.
Even though each of them was cleared by a physician, all still had migraines and balance problems.
They found answers at Children's National Medical Center in Washington, D.C., where they now go for physical therapy and cognitive testing.
"'Cleared' is different from 'healed,'" said Cailin's mother, Kelly Davis.
Since 2010, when the Virginia General Assembly required each school division to develop policies on identifying and handling concussions sustained by student-athletes, each locality has its own protocol in dealing with traumatic head injuries.
The goals of the Student-Athlete Protection Act are simple: "to ensure that student-athletes who sustain concussions are properly diagnosed, given adequate time to heal and are comprehensively supported until they are symptom-free."
The Virginia Board of Education guidelines for concussions also note that awareness among educators is important.
"Impairments can be mild or severe, temporary or permanent, resulting in partial or total loss of function. Because these deficits are so varied and unpredictable, it is difficult to forecast the recovery for a student with a brain injury," it states.
Spotsylvania County Schools developed a policy relating to student-athlete concussions sustained during extracurricular activities, which includes a concussion management team and its responsibilities; required education for coaches, athletes and parents; protocol for removing an athlete from extracurricular physical activity; and return-to-play protocol.
High school principals and activities directors are responsible for assuring each affected athlete, coach and parent have received concussion education.
Additionally, each high school has a certified athletic trainer, who is responsible for protocols and ImPact testing, which Spotsylvania instituted at the end of 2011.
The ImPact test provides baseline data about an athlete to enable a comparison of pre-concussion and post-concussion cognitive ability.
Activities director Ronnie Lowman said one of the biggest achievements since instituting the regulations is awareness.
"Athletes are much more aware of the risks and willing to report concussive symptoms," Lowman said. "Parents are more aware of the risks and willing to take student-athletes for medical attention. Coaches are more aware of the symptoms and the return-to-play protocols."
During the 20122013 school year there were 157 reported concussions in school-sponsored sports in Spotsylvania County high schools.
Through the fall and winter seasons of the current school year, there have been 104 reported concussions in school-sponsored sports.
During the 2012-13 school year football players sustained the most concussions, 57. Girls soccer players sustained 22 concussions and cheerleaders reported 19.
Lowman said the division will continue to study the most recent technology and best practices in concussion management.
Concussion research is still a relatively new field, though, and new research points to an increased likelihood that high school players will receive a greater number of concussions than their college and professional counterparts.
A recent study by a panel of medical experts convened by the National Academy of Sciences and funded by the NFL says high-schoolers are nearly twice as likely to suffer a brain injury as college players.
The 306-page report showed that college football players suffer concussions "at a rate of 6.3 per 10,000 practices or games."
For high school football players, the figure increases to 11.2.
The report also noted that current testing tools conclude most concussion symptoms have abated within two weeks, but 10 to 20 percent of concussion sufferers "are still experiencing symptoms anywhere from weeks to months to years later."
Brie, however, still has issues with memory, balance and sleep six months after her concussions.
She still has a hard time with physical therapy tests, and her injury has delayed her being able to drive independently.
She, Katie, Emily and Cailin want people to understand the persistent symptoms of concussions so classmates who sustain them in the future will be treated with compassion.
"More awareness is needed so no one feels alone," Katie said.
Information from: The Free Lance-Star, http://www.fredericksburg.com/